Vinegar Ingestion for Diabetes

Overseen By Carol Johnston, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Arizona State University

Must not be taking: Insulin

Disqualifiers: Non-typical diet, Acute illness, Smoking, others

Compensation: Varies

Number of Visits: 2

Duration: 9 days

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how daily vinegar intake might help manage blood sugar levels in people with glucose intolerance, using continuous glucose monitoring for better insights. Participants will either take a vinegar pill or drink liquid vinegar diluted in water with meals. It suits adults who struggle with blood sugar management, have been diagnosed with prediabetes or diabetes, or have had gestational diabetes. Those not on restrictive diets and willing to try vinegar are a good fit.

As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could lead to new dietary recommendations for managing blood sugar.

Will I have to stop taking my current medications?

The trial requires that your medication use has been consistent for the previous 3 months and will not be discontinued during the trial. If you plan to stop any medications, you may not be eligible to participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that taking vinegar daily might be safe for people with diabetes. In various studies, participants who consumed vinegar experienced better blood sugar levels without major side effects. For instance, one study found that regular vinegar use helped lower hemoglobin A1c levels, an important measure of long-term blood sugar control, in people with type 2 diabetes. Another study found that fasting blood sugar levels were significantly lower in those who took vinegar before bed.

While these results suggest that vinegar is generally safe, it is important to remember that vinegar is not a replacement for diabetes medication. No serious side effects were reported in these studies, indicating that vinegar could be a safe addition to diabetes management. However, anyone interested should consult a healthcare provider before starting any new treatment. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about vinegar ingestion for diabetes because it offers a natural and potentially safer alternative to traditional medications like metformin and insulin. Unlike standard treatments that primarily focus on managing blood sugar through synthetic drugs, vinegar works by possibly enhancing insulin sensitivity and slowing down the absorption of sugar. The study explores both a vinegar pill and liquid vinegar, with the latter being an easily accessible and widely available dietary option. This approach could simplify diabetes management and reduce reliance on conventional drugs, sparking interest in its potential benefits and simplicity.

What evidence suggests that daily vinegar ingestion might be an effective treatment for glucose intolerance?

Research has shown that vinegar, particularly apple cider vinegar (ACV), might help control blood sugar levels in people with type 2 diabetes. One study found that taking ACV daily helped manage blood sugar and improve cholesterol. Another review noted that vinegar can quickly aid in sugar processing, especially for those with type 2 diabetes. In this trial, participants will receive either a liquid vinegar treatment or a vinegar pill placebo. Although ACV is not a cure for diabetes, it can slightly lower blood sugar levels, potentially assisting in managing the condition alongside other treatments. Overall, evidence suggests that vinegar may positively affect blood sugar control. ^{1 2 5 6 7}

Are You a Good Fit for This Trial?

This trial is for adults who have trouble keeping their blood sugar levels stable, known as glucose intolerance. It's not clear what specific conditions exclude someone from participating, but typically these might include allergies to vinegar or serious health issues that could interfere with the study.

Inclusion Criteria

Sedentary or moderately active (defined as a score ≤ 24 on the Godin-Shepard Leisure Time Physical Activity Questionnaire)

I have high blood sugar or a history of diabetes.

Exclusion Criteria

I am currently experiencing an acute illness.

I am not willing to drink vinegar.

Currently adhering to a non-typical diet that would impact carbohydrate intake (including weight loss diets)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants are randomly assigned to consume either red wine vinegar or a placebo for 4 days, then switch to the opposite treatment for another 4 days.

9 days

2 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

1-2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Daily Vinegar Ingestion

Trial Overview

The study is testing how daily intake of vinegar affects blood sugar control over a full day. Participants will either drink liquid vinegar or take a vinegar pill and use continuous glucose monitoring to track changes in their blood sugar levels.

How Is the Trial Designed?

Group I: Liquid vinegar Experimental Treatment 1 Intervention

Liquid vinegar (6% acidity) consumed at a dosage of 2 tablespoons (diluted in water and consumed at mealtime) twice daily (4 tablespoons total per day).

Group II: Vinegar pill Placebo Group 1 Intervention

One pill consumed daily in the morning.

Who Is Running the Clinical Trial?

Arizona State University

Lead Sponsor

Trials

311

Recruited

109,000+

Published Research Related to This Trial

Vinegar, particularly its main component acetic acid, has been shown to improve glycemic control more effectively in normal glucose-tolerant individuals than in those with type 2 diabetes or impaired glucose tolerance, based on data from human intervention trials.

The mechanisms by which vinegar enhances glycemic control include activating specific receptors that increase GLP-1 secretion, enhancing AMPK activation for better fatty acid metabolism, reducing circulating free fatty acids to improve insulin sensitivity, and promoting satiety, which collectively contribute to better blood sugar management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vinegar as a functional ingredient to improve postprandial glycemic control-human intervention findings and molecular mechanisms. Lim, J., Henry, CJ., Haldar, S.[2022]

In a study involving 10 patients with type 1 diabetes and diabetic gastroparesis, apple cider vinegar significantly reduced the gastric emptying rate, with median values of 27% without vinegar and 17% with vinegar (p < 0.05).

The findings suggest that while vinegar may have benefits in healthy individuals, its effect of further delaying gastric emptying in diabetes patients could negatively impact their glycemic control.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. Hlebowicz, J., Darwiche, G., Björgell, O., et al.[2021]

In a randomized crossover study with 11 participants with type 2 diabetes, vinegar consumption before a meal significantly increased glucose uptake in muscle and reduced post-meal plasma glucose, insulin, and triglyceride levels.

The study suggests that vinegar may improve insulin action in skeletal muscle, contributing to better glucose metabolism without affecting fat breakdown, indicating its potential as a dietary intervention for managing blood sugar levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vinegar Consumption Increases Insulin-Stimulated Glucose Uptake by the Forearm Muscle in Humans with Type 2 Diabetes. Mitrou, P., Petsiou, E., Papakonstantinou, E., et al.[2019]

Apple cider vinegar (ACV) supplementation significantly improved antioxidant enzyme activities and reduced markers of liver and kidney toxicity in diabetic rats, indicating its potential protective effects against diabetes-related complications.

ACV also demonstrated antihyperglycemic effects by lowering blood glucose levels and enhancing the overall antioxidant defense system, suggesting it could be beneficial for managing diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Antidiabetic and Antioxidant Effects of Apple Cider Vinegar on Normal and Streptozotocin-Induced Diabetic Rats. Hmad Halima, B., Sarra, K., Jemaa Houda, B., et al.[2019]

Daily ingestion of acetic acid in the form of vinegar led to a modest reduction in hemoglobin A1c levels by 0.16% in diabetic patients, indicating improved glycemic control.

In contrast, the use of vinegar pills and dill pickles resulted in slight increases in hemoglobin A1c levels, suggesting that not all forms of acetic acid consumption are equally effective for managing blood sugar.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preliminary evidence that regular vinegar ingestion favorably influences hemoglobin A1c values in individuals with type 2 diabetes mellitus. Johnston, CS., White, AM., Kent, SM.[2022]

In a study involving 12 healthy young adults, liquid vinegar significantly reduced postmeal glucose levels by 31% compared to a control and commercial vinegar tablets, indicating its efficacy in managing postprandial glycemia.

Commercial vinegar tablets, when taken whole, were found to be less effective than liquid vinegar in lowering postmeal glucose excursions, suggesting that the form of vinegar consumed may impact its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Commercial Vinegar Tablets Do Not Display the Same Physiological Benefits for Managing Postprandial Glucose Concentrations as Liquid Vinegar. Feise, NK., Johnston, CS.[2022]

In a study involving 5 subjects, vinegar ingestion before a carbohydrate meal resulted in a modestly greater rate of glucose rise compared to a placebo, indicating that vinegar does not reduce blood sugar levels by affecting carbohydrate absorption.

The study utilized an oral octreotide/insulin suppression test to suppress insulin secretion, allowing researchers to better understand the effects of vinegar on glucose absorption, although the exact mechanism of vinegar's antiglycemic effects remains unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects. Salbe, AD., Johnston, CS., Buyukbese, MA., et al.[2013]

A systematic review of six studies involving 317 adults with type 2 diabetes showed that vinegar consumption significantly improved fasting blood glucose and hemoglobin A1c (HbA1c) levels, indicating better glycaemic control.

The analysis also revealed reductions in total cholesterol and low-density lipoprotein levels after vinegar consumption, suggesting additional cardiovascular benefits, although the variability in vinegar content and small sample sizes warrant caution in generalizing these results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review and meta-analysis: Vinegar consumption on glycaemic control in adults with type 2 diabetes mellitus. Cheng, LJ., Jiang, Y., Wu, VX., et al.[2020]

In a 12-week study involving 27 participants with type 2 diabetes, vinegar (VIN) ingestion was found to be generally safe, but 50-56% of those consuming pickles or VIN reported treatment-emergent adverse events, compared to only 11% in the reference group.

Chronic ingestion of VIN significantly reduced urinary pH and showed a tendency to increase liver enzyme levels, suggesting that VIN may affect liver function and metabolic pathways beyond just glucose metabolism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A preliminary evaluation of the safety and tolerance of medicinally ingested vinegar in individuals with type 2 diabetes. Johnston, CS., White, AM., Kent, SM.[2013]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10679383/

The improvement effect of apple cider vinegar as a ...

Conclusion. Daily consumption of ACV may have beneficial effects in controlling blood glucose indices and lipid profile in patients with type 2 diabetes.

2.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S2405457719303055

Review Vinegar (acetic acid) intake on glucose metabolism

Vinegar (acetic acid) intake improves acutely the glucose metabolism. The effects occur manly in subjects with type 2 diabetes mellitus.

3.

uchicagomedicine.org

uchicagomedicine.org/forefront/health-and-wellness-articles/2018/august/debunking-the-health-benefits-of-apple-cider-vinegar

Debunking the health benefits of apple cider vinegar

Bottom line: ACV won't cure diabetes, but it may moderately lower blood glucose levels. It won't take the place of any medications for diabetes, ...

4.

clinicaltrials.gov

clinicaltrials.gov/study/NCT03593135?term=APPLE%20CIDER%20VINEGAR&view=&rank=3

Effect of Apple Cider Vinegar in Type 2 Diabetics

A study conducted in pre-diabetic healthy individuals showed significant (p=0.05) reduction in HbA1C, in apple cider vinegar group . Many RCTs of human and ...

5.

frontiersin.org

frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1528383/full

Effects of apple cider vinegar on glycemic control and ...

Each 1 mL/day increase in ACV consumption was associated with a-1.255 mg/dL reduction in FBS. Moreover, greater effects on FBS were in dosages >10. Conclusion: ...

6.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S0168822709000813

Preliminary evidence that regular vinegar ingestion ...

Brief report. Preliminary evidence that regular vinegar ingestion favorably influences hemoglobin A1c values in individuals with type 2 diabetes mellitus.

7.

diabetesaction.org

diabetesaction.org/article-vinegar

Vinegar Benefits for Diabetes

The results of the study demonstrated morning fasting blood sugars were significantly lower when participants took the bedtime vinegar!